PECARN Paediatric Head Injury
Decision rule for CT head in children with head injury. Minimises radiation exposure. Two algorithms: < 2 years and ≥ 2 years.
Score interpretation
No risk factors present. ciTBI risk < 0.02%. CT not recommended.
→ Discharge with head injury advice card. Return if: worsening headache, persistent vomiting, unusual drowsiness, seizure, behaviour change.
Minor risk factors present. Individualised decision: observation vs CT.
→ Shared decision-making with parents. Observation for 4–6 hours is acceptable alternative to immediate CT. CT if concern worsens.
GCS < 15, altered mental status, or skull fracture signs. CT head required immediately.
→ CT head immediately. Neurosurgery on standby if significant intracranial injury found.
Interpretation bands for the PECARN. Apply clinical judgement and local guidance.
References
- Kuppermann N et al. Identification of children at very low risk of clinically-important brain injuries after head trauma. Lancet. 2009.
Related
Curated clinical cross-links plus same-class fallbacks.
- Cetuximab · Anti-EGFR Monoclonal Antibody — Head and Neck Cancer
- Cisplatin · Platinum Chemotherapy — Head and Neck Cancer
- Methotrexate · Chemotherapy / Immunosuppressant — Head and Neck / Granulomatosis
- Pembrolizumab (Head and Neck SCC) · PD-1 Inhibitor
- Nivolumab (Head and Neck SCC) · PD-1 Inhibitor
- Melatonin · Melatonin Receptor Agonist
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.